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NPI Code Detail

MEDICARE: MR. MERRILL PAUL ANDERSON PH.D.

MEDICARE: MR. MERRILL PAUL ANDERSON PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist22182TX

General Provider Information

NPI Number : 1932123130
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MERRILL PAUL ANDERSON PH.D.
Provider Business Mailing Address
First Line : 5959 WEST LOOP S STE 430
Second Line :
City : BELLAIRE
State : TX
Zip : 77401-2403
Country : US
Telephone Number : 713-444-1047
Fax Number : 713-661-1324
Provider Business Practice Location Address
First Line : 5959 WEST LOOP S STE 430
Second Line :
City : BELLAIRE
State : TX
Zip : 77401-2403
Country : US
Telephone Number : 713-444-1047
Fax Number : 713-661-1324
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2006
Last Update Date : 07/09/2007

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